It has been estimated that 60,000 Iranians have been infected with HIV/AIDS and only 36% of them are aware of their status. This study aimed to design, implement and evaluate a social marketing ...campaign to promote HIV testing in Boyer-Ahmad County, Kohgiluyeh, and Boyer-Ahmad Province, southwest of Iran.
This study was a quasi-experimental pretest-posttest without a control group, developed based on a social marketing assessment and response tool. To design the intervention formative research was conducted, comprised of four focus group discussion sessions with 42 participants of the target community along with seven in-depth semi-structured personal interviews with health care providers involved in the HIV/AIDS Program. Data analysis was done manually using content analysis and the main content was formulated for the campaign. Afterward, the slogan and messages of the campaign were developed. The campaign's materials including banners, posters, pamphlets, referral forms, and short messages were designed, pretested, and revised. Ultimately, the campaign was conducted for one month in October 2019. To determine the effectiveness of the campaign, the rate of referrals to the Center for Behavioral Health Counseling Services (CBHCS), for three months before and after the campaign, was compared.
Qualitative findings identified that the majority of the interviewees mentioned that the main reasons for the low rate of referrals to get tested for HIV were lack of awareness and information about HIV/AIDS and its diagnosis as well as the free and confidential tests available from the CBHCS. Moreover, the stigma associated with HIV/AIDS was another important reason for low referrals for testing. The rate of referrals for HIV testing in the three months leading up to the campaign was 18, 32, and 23 people, and three months after the campaign was 64, 81, and 44 individuals; respectively. The results of the multivariate analysis demonstrated that the campaign had increased the rates of referrals for HIV testing through its significant influence on females, and individuals with academic degrees.
It can be concluded that the social marketing campaign was successful in persuading people to get tested for HIV.
The objective of this investigation is to evaluate the consistency of intra-rater and inter-rater assessments utilizing ultrasound elastography to examine the muscle stiffness of the popliteus and ...gastrocnemius (medial and lateral heads) in patients with knee osteoarthritis accompanied by myofascial trigger points.
Thirty individuals with knee osteoarthritis accompanied by myofascial trigger points were assessed. Two examiners independently measured the muscle stiffness levels of the popliteus and gastrocnemius (medial and lateral heads) three times using ultrasound elastography in the first session. The second session was conducted one week later.
In the initial test session, the mean shear modulus values for the popliteus and gastrocnemius (medial and lateral heads) muscles were measured as follows for tester 1 (12.75, 13.72, 14.13 kPa) and tester 2 (11.66, 12.81, 13.17 kPa). During the retest session, the previously measured variables by tester 1 and tester 2 yielded the following values: (12.61, 13.43, 14.26 kPa) and (11.62, 12.87, 13.30 kPa) respectively." Good to excellent intra-rater reliability (ICC = 0.912-0.986) and inter-rater reliability (ICC = 0.766-0.956) were reported for the shear moduli of the popliteus, medial and lateral gastrocnemius muscles.
The assessment of muscle stiffness in the popliteus and gastrocnemius (medial and lateral heads) using ultrasound elastography is a reliable method in patients with knee osteoarthritis accompanied by myofascial trigger points.
Violence against women is an urgent health priority in Iran. Designing effective programs for preventing and controlling the problem necessitates a thorough understanding of Iranian women and their ...perspectives regarding domestic violence. This study was aimed at exploring the domestic violence–related views of married women who were referred to health care facilities in Ahvaz, Iran. In this qualitative research, data were collected through four focus group discussions with 30 married women. All the discussions were recorded and transcribed, after which the data were classified separately. The main themes and subthemes were then manually derived from the data and analyzed. The five main themes identified were domestic violence against women in Ahvaz, behavioral influencing factors, nonbehavioral influencing factors, the necessity to empower women to prevent domestic violence, and recommendations for developing special training programs for Ahvazi women. Most of the participants were aware that domestic violence against women is a common occurrence in Iran. They were well aware of the definition of violence and expressed a belief that behavioral factors exert an important effect on the occurrence of the problem. They recommended the development of appropriate training programs that empower women to prevent the problem, the use of mass media to educate citizens about domestic violence, and the involvement of opinion leaders in eliminating the taboo against considering such violence a crime against Iranian women. Considering the views and ideas of women as consumers of educational services is a principle used to develop effective programs for preventing and controlling domestic violence. As indicated by the findings, the participants believe that empowering women must be treated as a priority in the Iranian health care system. However, they recommended differing approaches and methods of empowerment on the basis of their individual views and concerns.
WHO has recommended that the average salt intake must be <5 grams per day. However, people consume salt much more in many countries. In this study, we design and implement an intervention based on ...social marketing model to reduce salt consumption in Yasuj, Iran.
This study employed a quasi-experimental pretest-posttest with control group design which consisted of a formative research (qualitative-quantitative) and an interventional phase. To collect the qualitative data, six focus group discussions by participating of 66 people were established. The qualitative data were analyzed manually using directed content analysis. In quantitative study, 166 people aged 25-50 years completed a KAP questionnaire, and their average salt intake was determined through measuring sodium in their urine sample. By analyzing the data, marketing mix components were determined for designing an intervention. An educational package (including posters for installing in the kitchen, pamphlets, phone counseling, four educational classes, and brief interventions done by physicians and other health personnel) focused on reducing salt intake and using alternatives was developed. For one month, program was implemented for intervention group. Two months later, KAP survey and measuring the urine sodium were repeated for intervention and control groups. The data was compared for two groups, before and after the intervention by using independent t-test, paired t-tests and repeated measures ANOVA.
The qualitative findings showed that most participants agreed that the salt intake was high in Iran. Most of them recommended home-based and family-driven strategies to reduce salt intake, offered using healthier alternatives for salt, and recognized physicians and health care providers in healthcare facilities as the most important to encourage people to reduce salt intake. After the intervention, the mean and standard deviation of KAP were improved significantly in intervention group. The mean salt intake decreased significantly by 3.01 ± 2.38 in the intervention group and repeated measures ANOVA showed significant change over time (
< 0.001) and a significant difference between two groups (
= 0.04)
Also, the interaction between time and group was significant (
= 0.001).
The mean salt intake among the study population was approximately three times more than the level recommended by the WHO. The social marketing-based intervention succeeded in reducing the salt intake of the study subjects by ~3 grams on average.
Iran has a low incidence but higher rate of death from cervical cancer (CC). The country is in the process of implementing an organized screening program including HPV testing and cytology. Studies ...show high dropout in continued testing among eligible women. This qualitative study aimed to explore women's awareness regarding CC and CC testing and the role of knowledge, perceived risk, and cues to action in this process.
Through a qualitative study based on the Framework Method, we recruited 81 women aged 25-65 who participated in 15 focus group discussions (FGDs) and two in-depth interviews in Tehran. The interviewees were selected purposefully during January to May 2015 from households belonging to different socioeconomic classes until data saturation. The data were acquired through 11 open-ended questions and 32 related probe questions. All interviews were transcribed and independently analyzed by two researchers (Kappa and agreement testing respectively: 0.77, 97.11%).
The coded texts were categorized under three themes and 13 subthemes. The three thematic areas referred to knowledge, cues to action, and perceived risks regarding CC and screening. The results showed that women had limited and unspecified knowledge about CC and screening, compounded by misconceptions regarding infection and cancer prevention measures. Social and cultural barriers hindered proper communication between health system/providers and clients and within communities on subjects related to CC and screening. The perceived risk of getting CC was low because of overestimating the role of hereditary factors for CC, difficulty in differentiating between cancer and sexually transmitted infections (STI), and the absence of visible symptoms.
The results indicate a strong need to invest more efforts to improve health education and communication in the current national health program to promote awareness of the need to screen for CC through, for example, establishing correct knowledge and risk perceptions among women. In addition, this intervention should address women's social environment in order to prevent misconceptions being communicated to women.
BackgroundSkin cancer is one of the most preventable diseases. The purpose of this study is to describe a social marketing-based intervention design protocol to promote sun-protective behaviors among ...adolescent boys living in urban areas in Yasuj, south west of Iran. MethodsThis study will be conducted based on six specific steps including a qualitative study, a systematic review, development of appropriate tools, a cross-sectional study, intervention designing, and a feasibility study. The main objective of the qualitative study is to elicit the views and opinions of adolescent boys, their parents, and teachers about sun-protective behaviors. In the second step, factors affecting sun-protective behaviors will be reviewed systematically. Based on the findings of the first and second steps, an appropriate model/theory of behavior change will be selected, and a standardized questionnaire will then be developed. In the fourth step, a cross-sectional survey will be conducted using the developed questionnaire to assess current sun-protective behavior practices. ResultsFindings of the first to fourth stages will provide a comprehensive picture of the issue and the affecting factors. During the fifth step, the structure and the content of the intervention package, as well as educational and promotional materials, will be developed and pre-tested. Finally, in the sixth step, a feasibility study will be conducted. ConclusionThis study will provide practical information on the achieving of content and construct of a community-based social marketing intervention. This protocol reports on how to achieve audience-oriented insights for designing a tailored intervention aimed at promoting sun-protective behaviors among adolescent boys using social marketing.
Introduction. In Iran, the rate of cesarean section is three times more than the acceptable rate considered by the World Health Organization. This study aimed at reducing the selection of cesarean ...section by primigravida through an intervention based on social marketing in Boyer-Ahmad County, Iran, 2015. Methods. In this field trial, 39 of primigravida women were identified and selected as a target group. Formative research (a quantitative survey and a qualitative study) was done to achieve the social marketing mix. The tailored intervention was developed based on the findings of formative research. The intervention was implemented for one month for pregnant women who had cesarean section intention. Their intention for the cesarean section was studied again one month after the implementation of the intervention. The effectiveness of the intervention was evaluated by the proportion test. Results. The average age of the women was 25.82. All of the women 38.5 percent had a diploma degree and lower than and 61.5 percent had a university degree. Before the intervention, 39 women intended to do Cesarean. The intention of 30 pregnant women was changed significantly one month after the intervention. Conclusion. The study showed the effectiveness of an intervention based on consumer-oriented social marketing theory and could be used to reduce Cesarean intention. More studies about related factors of vaginal delivery selection especially from behavioral intention up to behavior are suggested.
The Polycyclic Aromatic Hydrocarbons (PAHs) bound to ambient fine Particular Matter (PM
2.5
) are currently drawing a lot of attention due to their adverse health effects increasing lung cancer risk ...in humans. In this study, The PM
2.5
samples were collected by high volume air samplers simultaneously from three different sites (high-traffic roadside, urban background, and remote suburban) in Tehran, Iran during warm and cold seasons (from July 2018 to March 2019), and 16 PAHs were analyzed using Gas Chromatography-Mass Spectrometry (GC–MS). Unlike previous studies, a remote suburban area was chosen so as to observe the spatial differentiation in PM
2.5
-bound PAH characteristics. In high-traffic roadside site, the average concentration of total PM
2.5
-bound PAHs (ƩPAHs) was 3.7 times the concentration value in remote suburban area. Average (ƩPAHs) ranged from 5.54 ng/m
3
for remote suburban area to 20.67 ng/m
3
for high-traffic roadside site. In all sites, seasonal trends of PAH concentrations elucidated high concentrations in the cold season and low concentrations in the warm season. Correlation analysis between ƩPAHs and atmospheric factors (meteorology parameters and criteria air pollutants) indicated the heterogeneous processes play an important role in the level of PAHs. The results of diagnostic ratio (DR) analysis disclosed that the dominant source of PM
2.5
-bound PAHs was the combustion of liquid fossil fuels. Despite the fact that incremental lifetime cancer risk (ILCR) via inhaling PM
2.5
-bound PAHs varied significantly in high-traffic roadside site and remote suburban site, its value was beyond the acceptable risk level in both sites. Our results suggested that effective regulations are needed to monitor PAHs concentrations and reduce PAHs emissions from liquid fossil fuel combustion so as to mitigate the potential carcinogenic risk of PAHs in ambient air.
Highlights
• PAHs of PM
2.5
was studied at roadside, urban background, and remote suburban sites.
• Correlations of ƩPAHs with meteorological parameters were investigated.
• Total PAHs in cold season was three times that of warm season at three sites.
• The combustion of liquid fossil fuels was dominant source of PAHs emission.
• ILCR values of PAHs in both urban sites exceeded serious risk levels.
Background and Objective: Increasing the level of health awareness of food preparation and distribution staff can have a direct impact on improving the level of public health in the community. ...Education can change people's knowledge, attitudes, and practices. Health education courses that provide integrated education as well as to other education systems, include educational inputs, processes, and outputs. The objective of this research is to evaluate these elements of the educational system of health education courses in Shiraz. Materials and Methods: The current study evaluated the educational input, process, and output of 7 current health education institutions in Shiraz. Factors that influence the input of educational courses were evaluated using an inspection checklist of health education courses, the educational process was measured employing a satisfaction survey, and the educational output was assessed through a checklist of inspection of Article 13 of the Regulations. The health performance of 160 guild health certified units and 160 uncertified education units was analyzed as a criterion for effectiveness. Data were analyzed using the IBM SPSS21 software. Data related to the assessment of the input and educational process were analyzed using the Spearman correlation coefficient. Mann-Whitney and Kruskal-Wallis non-parametric statistical tests were also used for cross-group comparisons of output evaluation data. Results: The findings of the educational input evaluation showed a strong correlation and a significant relationship between the overall evaluation score of the educational courses and the "observation" (0.96) "educational course principal" (0.94). Also, in the process evaluation, the "educational environment" and "general educational programs" with correlation coefficients of 0.99 and 0.84 had the most correlation with the overall process evaluation score. In all the health fields studied, there was a significant difference (p = 0.001) between the average score obtained for educational courses with and without certificates. There was a significant difference (p <0.0001) between the mean score obtained by public health with and without health certification. The average score obtained by the certified public and non-public places was 91.81 and 70.71, respectively. Conclusion: Health education can have a major impact on people's health performance. Some of the elements that make up the educational output have a greater impact on achieving the desired educational output. For example, the revision and updating of the educational content and the development of the educational program according to all groups of learners can improve the performance of the learning process and the satisfaction of learners.
Purpose: This study aimed to compare the effectiveness of physiotherapy with uphill walking versus physiotherapy alone on the disability of patients with knee osteoarthritis. Methods: This study was ...a randomized clinical trial carried out on 30 patients (5 males and 25 females) with moderate knee osteoarthritis aged between 40 and 65 years. They were assigned to the intervention and control groups. Both groups received 10-session routine physiotherapy, and the intervention group received an 8-degree treadmill walking at a speed of 1.1m/s for 30 minutes in each session. The participants’ disability was measured before, immediately after, and 20 days after the 10-session treatment by the Persian version of Knee injury and Osteoarthritis Outcome Score (KOOS). The data were analyzed through the repeated measures analysis of variance in SPSS V. 22. The significant level was set at 0.05. Results: Statistical analysis showed significant improvements in the activity of daily living (P≤0.01) and quality of life (P<0.05) in both groups, with these improvements being persistent up to the 20th day (P<0.02). Other subscales included Symptoms, pain, and sports functions improved only in the intervention group (P≤0.01), and these improvements were persistent up to the 20th day (P≤0.003). Conclusion: This study showed that physiotherapy combined with uphill walking versus physiotherapy alone results in improvements in pain, other symptoms, and sports function subscales of patients with moderate knee osteoarthritis. These improvements were persistent up to the 20th day. Accordingly, it is recommended to include an 8-degree inclined treadmill walking to the routine physiotherapy program in the management of knee osteoarthritis.
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